Provider Demographics
NPI:1578154654
Name:FERRAN, KAYLEY PATRICIA (AGNP)
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:PATRICIA
Last Name:FERRAN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 YELLOWSTONE BLVD APT 3Q
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3166
Mailing Address - Country:US
Mailing Address - Phone:718-749-4043
Mailing Address - Fax:
Practice Address - Street 1:7025 YELLOWSTONE BLVD APT 3Q
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3166
Practice Address - Country:US
Practice Address - Phone:718-749-4043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309830363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner